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Background: Published best-practice guidelines and standardized protocols for voice assessment recommend multidisciplinary evaluation utilizing a comprehensive range of clinical measures. Previous studies report variations in assessment practices when compared with these guidelines. Aims: To provide an up-to-date evaluation of current global multidisciplinary practice patterns and the opinions of otolaryngologist, ear, nose and throat (ENT) and speech-language pathology (SLP) clinicians on initial assessment and differential diagnosis of adults with voice disorders (VDs). Methods & Procedures: ENTs and SLPs worldwide who had worked with VDs within the last 10 years completed an anonymous online survey. Themes explored demographic information about the clinical practice, information about diagnostic assessment pathways, clinical assessments routinely used for initial voice evaluation and clinician perceived value of clinical assessments important for diagnosis. Outcomes & Results: Patterns in the clinical practice of 88 SLPs and 21 ENTs from 18 countries with 1 to more than 25 years' experience were analysed. Clinicians provided services across a range of locations, and a range of assessment pathways was available for initial evaluation. Case history, laryngoscopy and auditory-perceptual measures were the most frequently selected assessments. Most clinicians favoured formal assessment measures for auditory-perceptual evaluation. Clinicians placed equal weighting on ENT and SLP assessment to aid diagnosis for muscle tension VDs and functional neurological voice disorders (FVDs). Conclusions & Implications: Practice patterns for initial diagnostic voice assessment are largely consistent with the currently published guidelines. Decisions for the selection of assessment tools vary according to VD classification, and assessment decisions appear to be guided by case history. Clinicians are not always following established protocols for obtaining reliable standardized measures. Further research is needed to understand the barriers to adhering to standardized protocols and to develop evidence for the use of case history in the process of VD diagnosis.

Background: 'Speech sound disorder' is an umbrella term that encompasses dysarthria, articulation disorders, childhood apraxia of speech and phonological disorders. However, differential diagnosis between these disorders is a persistent challenge in speech pathology, as many diagnostic procedures use symptom clusters instead of identifying an origin of breakdown in the speech and language system. Aims: This article reviews typical and disordered speech through the lens of two well-developed models of production--one focused on phonological encoding and one focused on speech motor planning. We illustrate potential breakdown locations within these models that may relate to childhood apraxia of speech and phonological disorders. Main Contribution: This paper presents an overview of an approach to conceptualisation of speech sound disorders that is grounded in current models of speech production and emphasises consideration of underlying processes. The paper also sketches a research agenda for the development of valid, reliable and clinically feasible assessment protocols for children with speech sound disorders. Conclusion: The process-oriented approach outlined here is in the early stages of development but holds promise for developing a more detailed and comprehensive understanding of, and assessment protocols for speech sound disorders that go beyond broad diagnostic labels based on error analysis. Directions for future research are discussed.

Many secondary school students' second language (L2) speaking skills suffer from deficiencies; the effects thereof are detrimental to their academic and career opportunities in a globalized world that highlights the importance of oral communication skills. Debate has been considered a potentially effective speaking pedagogical tool that can scaffold learning processes in ways that can lead to language development. This study investigates the effect of a debate intervention on English L2 speaking competence of Dutch secondary school students. Following a pretest-posttest control group design, we elicited speech samples from opinion tasks which we coded in terms of measures of speech quantity, fluency, complexity, accuracy and cohesion. Multilevel analysis results indicate that after the intervention, the intervention group produced more language which was more fluent, accurate, coherent and lexically more sophisticated relative to the control group. These findings, which have significant implications for L2 speaking development, are discussed in relation to specific characteristics of L2 debate pedagogy.

This study examined the collaborative practices between teachers and speech and language therapists (SLTs) within an inclusive setting, interviewing 17 professionals' couples. Three distinct phases of collaboration were identified: planning (e.g. reviewing student performance), co-teaching in the classroom, and evaluation (reflecting upon joint activities). Conditions fostering collaboration were categorized into individual (interpersonal relationships), school-based (directive management) and policy (current regulations) dimensions. Findings suggest that the extent of collaboration varies and is influenced by interconnected conditions. This research enriches the literature by offering a classification of collaborative work between teachers and SLTs and underscores the conditions impacting it, and is invaluable for stakeholders aiming to advance inclusive educational settings.

Background: People with aphasia (PWA) typically exhibit deficits in spoken discourse. Discourse analysis is the gold standard approach to assess language deficits beyond sentence level. However, the available discourse assessment tools are biased towards English and European languages and Western culture. Additionally, there is a lack of consensus on which discourse measures to use and limited evidence of the psychometric properties of published discourse measurements. Aims: (1) To develop a standardized, norm-referenced, culturally and linguistically appropriate Arabic Discourse Assessment Tool (ADAT); and (2) to examine the psychometric properties of content and construct validity and interrater reliability of different discourse measures elicited using three discourse genres (descriptive, narrative and procedural) in neurotypical control adults and matched PWA. Methods & Procedures: Discourse samples were collected using three novel discourse stimuli that are sensitive to the Arabic language and culture from 70 neurotypical control adults and a matched group of 50 PWA. Transcription agreement was assessed. A standard approach was used to evaluate construct validity and interrater reliability for 16 discourse measures that assess fluency, language productivity, information content, lexical--semantics, lexical diversity, grammatical category, grammatical structure and syntactic complexity. Strong measures were identified based on their psychometric properties, and normative data were established on these measures. Discourse performance of PWA was then examined using the newly developed tool (ADAT). Outcomes & Results: Transcription agreement was extremely high for all discourse stimuli in both groups. Eight discourse measures were proven to have consistently very high construct validity and consistently very good to excellent reliability across the three stimuli in both neurotypical control and aphasia groups: lexical information units, content information units, words per minute, discourse duration, number of different words, number of complete sentences and proportion of open and closed class words. Norms were established on these measures, and cut-off scores of impairments were determined. Other measures showed low construct validity and variable or poor reliability across the two groups. Conclusions & Implications: The newly developed, standardized, and norm-referenced tool (ADAT) consist of three discourse stimuli and eight high-quality discourse measures that assess multiple aspects of spoken discourse and were able to differentiate PWA from neurotypical adults consistently. ADAT also includes normative data and cut-off impairment scores. The tool has great potential to enhance clinical practice and research with Arabic speakers. Evidence was provided that not all discourse measures are of high quality, as some are vulnerable to differences between raters, discourse stimuli and groups. Clinicians and researchers can use ADAT for accurate aphasia assessments, better management plans and to monitor therapy effectiveness. ADAT can be further validated in other clinical populations with language impairments.

Background: The Scenario Test is recognised for its effectiveness in assessing the interactive aspects of functional communication in people with post-stroke aphasia (PWA). Aims: To develop a Japanese version of the Scenario Test (Scenario Test-JP) and assess its reliability and validity. Methods & Procedures: Among 66 participants, we selected 61 individuals: 34 PWA and 27 healthy controls (HCs). We modified the Scenario Test-JP based on the UK version and subsequently evaluated its reliability (internal consistency, test--retest and intra-rater and inter-rater reliabilities) and validity (convergent and discriminant) by comparing PWA and HCs. Outcomes & Results: The Scenario Test-JP showed strong reliability with a Cronbach's [alpha] of 0.93, test-retest reliability with an intraclass correlation coefficient (ICC) of 0.97, intra-rater reliability with an ICC of 0.95-1.00, and inter-rater reliability with an ICC of 0.96. The validity of the test was confirmed with concurrent scores ranging from [rho] = 0.37 to 0.76 (p < 0.05) and known-groups validity (p < 0.001, r = -0.56). Conclusions & Implications: The reliability and validity of the Scenario Test-JP align with those of the original Dutch version and the UK and Greek versions. Additionally, the assessment can now include extended alternative communication methods, such as digital devices, indicating the potential of the Scenario Test-JP for modern Japanese speech-language therapy.

This academic article has objectives were 1) to study the techniques in data analyzing of speech recognition systems techniques to detect reading aloud skills in Thai tonal conjugation for Primary Education Students, and 2) to study the effect of speech recognition systems techniques to detect reading aloud skills in Thai tonal conjugation for Primary Education Students. Sample group in this research were 30 Primary Education Students in Grades 4-6 of Wat Na Klang School in Nakhon Sawan Province, Thailand. Research tools was speech recognition systems techniques to detect reading aloud skills in Thai tonal conjugation. Results showed that, 1) the three techniques involved in sound analysis consisted of Spectrogram Sound Wave Change Techniques, Wavelet Transform Audio Format Conversion Techniques, and two sets of data similarity comparison techniques named Dynamic Time Warping (DTW). The researchers used three techniques in analysis and comparison for making the more similar to the sound signal than using a single technique to analyze. 2) the effect of using speech recognition system to detect reading aloud skills in Thai tonal conjugation showed results of pronunciation practice and compared the similarity of audio signals that after using the technique in 5 analytical times, the largest average result was 93.52 Percent, the least average result was 87.75 Percent, and the total average result was 90.66 Percent.

Introduction: Speech Language Therapy First Point of Contact Clinic (SLT-FPOCC) models can assist assessment of low-risk patient populations referred to ear, nose and throat (ENT) services. To further improve ENT waitlist management and compliance with best-practice care, consideration of other low-risk populations that could be safely managed through this service model is needed. The aims of this paper are to evaluate the clinical and service outcomes of completing vocal cord check (VCC) assessments for patients' pre and post thyroid/parathyroid surgery within an SLT-FPOCC model and examine consumer perceptions. Methods & Procedures: The service followed existing SLT-FPOCC procedures, with ENT triaging referrals, then SLT completing pre- and postoperative VCC assessment (interview, perceptual assessment, flexible nasendoscopy), with assessment data later reviewed by ENT to diagnose laryngeal pathology. Clinical and service outcomes were collected prospectively. Patients completed an anonymous post-service satisfaction survey. Results: Of the first 100 patients referred for preoperative VCCs, SLT assessment identified 42 with dysphonia and 30 reporting dysphagia, while ENT confirmed 9 with significant preoperative anatomical findings. Eighty-three underwent surgery, with 63 (95 nerves at surgical risk) returning for a postoperative VCC. Postoperative VCC identified three temporary neuropraxias (3.2%) and three unilateral vocal fold paresis (3.2%). Patients were highly satisfied with the service. All 163 pre-/postoperative VCCs were completed with no adverse events. Conclusion & Implications: The current data support SLT-FPOCC service expansion to include pre and post thyroid/parathyroid surgery VCC checks, with positive consumer perception. The model supports delivery of best practice management (i.e., pre- and postoperative VCC) for patients receiving surgery for thyroid/parathyroid dysfunction, and associated efficiencies for ENT services.

Purpose: Babble Boot Camp (BBC) is a parent-implemented telepractice intervention for infants at risk for speech and language disorders. BBC uses a teach-model-coach-review approach, delivered through weekly 15-min virtual meetings with a speech-language pathologist. We discuss accommodations needed for successful virtual follow-up test administration and preliminary assessment outcomes for children with classic galactosemia (CG) and controls at age 2.5 years. Method: This clinical trial included 54 participants, 16 children with CG receiving BBC speech-language intervention from infancy, age 2 years, five children receiving sensorimotor intervention from infancy and changing to speech-language intervention at 15 months until 2 years of age, seven controls with CG, and 26 typically developing controls. The participants' language and articulation were assessed via telehealth at age 2.5 years. Results: The Preschool Language Scale--Fifth Edition (PLS-5) was successfully administered with specific parent instruction and manipulatives assembled from the child's home. The GFTA-3 was successfully administered to all but three children who did not complete this assessment due to limited expressive vocabularies. Referrals for continued speech therapy based on PLS-5 and GFTA-3 scores were made for 16% of children who received BBC intervention from infancy as compared to 40% and 57% of children who began BBC at 15 months of age or did not receive BBC intervention, respectively. Conclusions: With extended time and accommodations from the standardized administration guidelines, virtual assessment of speech and language was possible. However, given the inherent challenges of testing very young children virtually, in-person assessment is recommended, when possible, for outcome measurements.

Procedures and practices that are ableist in the educational system have been long overlooked. Speakers having differing abilities than neurotypical or able-bodied individuals is often not something that is considered in basic course assessment tools. This is important to address because although there are institutional policies and procedures in place to help students with differing abilities, instructors of public speaking have the autonomy or power to determine how such accommodations will affect the speech grade determined by the assessment tool. Power relations are significantly complicated in educational settings when strict hierarchies are imposed, and when instructors abuse their authority, which might lead to unequal power dynamics, especially at the beginning of a course, because the instructor holds power in shaping the course. Additionally, since assessment tools such as rubrics reinforce societal norms, they can also encourage bias from the instructor (Ashby-King et al., 2021). This analysis will examine current assessment tools used by instructors in the public speaking course from a critical disability lens paired with rhetorical content analysis to uncover ableist perspectives.

The current study investigated whether the difficulty in finding group differences in prosody between speakers with autism spectrum disorder (ASD) and neurotypical (NT) speakers might be explained by identifying different acoustic profiles of speakers which, while still perceived as atypical, might be characterized by different acoustic qualities. We modelled the speech from a selection of speakers (N = 26), with and without ASD, as a network of nodes defined by acoustic features. We used a community-detection algorithm to identify clusters of speakers who were acoustically similar and compared these clusters with atypicality ratings by naïve and expert human raters. Results identified three clusters: one primarily composed of speakers with ASD, one of mostly NT speakers, and one comprised of an even mixture of ASD and NT speakers. The human raters were highly reliable at distinguishing speakers with and without ASD, regardless of which cluster the speaker was in. These results suggest that community-detection methods using a network approach may complement commonly-employed human ratings to improve our understanding of the intonation profiles in ASD.

Background: The detection and description of language impairments in neurodegenerative diseases like Alzheimer's Disease (AD) play an important role in research, clinical diagnosis and intervention. Various methodological protocols have been implemented for the assessment of morphosyntactic abilities in AD; narrative discourse elicitation tasks and structured experimental tasks for production, offline and online structured experimental tasks for comprehension. Very few studies implement and compare different methodological protocols; thus, little is known about the advantages and disadvantages of each methodology. Aims: To discuss and compare the main behavioral methodological approaches and tasks that have been used in psycholinguistic research to assess different aspects of morphosyntactic production and comprehension in individuals with AD at the word and sentence levels. Methods: A narrative review was conducted through searches in the scientific databases Google Scholar, Scopus, Science Direct, MITCogNet, PubMed. Only studies written in English, that reported quantitative data and were published in peer-reviewed journals were considered with respect to their methodological protocol. Moreover, we considered studies that reported research on all stages of the disease and we included only studies that also reported results of a healthy control group. Studies that implemented standardized assessment tools were not considered in this review. Outcomes & Results: The main narrative discourse elicitation tasks implemented for the assessment of morphosyntactic production include interviews, picture-description and story narration, whereas the main structured experimental tasks include sentence completion, constrained sentence production, sentence repetition and naming. Morphosyntactic comprehension in AD has been assessed with the use of structured experimental tasks, both offline (sentence-picture matching, grammaticality judgment) and online (cross-modal naming, speeded sentence acceptability judgment, auditory moving window, word detection, reading). For each task we considered studies that reported results from different morphosyntactic structures and phenomena in as many different languages as possible. Conclusions & Implications: Our review revealed strengths and weaknesses of these methods but also directions for future research. Narrative discourse elicitation tasks as well as structured experimental tasks have been used in a variety of languages, and have uncovered preserved morphosyntactic production but also deficits in people with AD. A combination of narrative discourse elicitation and structured production tasks for the assessment of the same morphosyntactic structure has been rarely used. Regarding comprehension, offline tasks have been implemented in various languages, whereas online tasks have been mainly used in English. Offline and online experimental paradigms have often produced contradictory results even within the same study. The discrepancy between the two paradigms has been attributed to the different working memory demands they impose to the comprehender or to the different parsing processes they tap. Strengths and shortcomings of each methodology are summarized in the paper, and comparisons between different tasks are attempted when this is possible. Thus, the paper may serve as a methodological guide for the study of morphosyntax in AD and possibly in other neurodegenerative diseases.

Purpose: This study examined how speakers adapt to fundamental frequency (f[subscript o]) errors that affect the use of prosody to convey linguistic meaning, whether f[subscript o] adaptation in that context relates to adaptation in linguistically neutral sustained vowels, and whether cue trading is reflected in responses in the prosodic cues of f[subscript o] and amplitude. Method: Twenty-four speakers said vowels and sentences while f[subscript o] was digitally altered to induce predictable errors. Shifts in f[subscript o] (±200 cents) were applied to the entire sustained vowel and one word (emphasized or unemphasized) in sentences. Two prosodic cues--f[subscript o] and amplitude--were extracted. The effects of f[subscript o] shifts, shift direction, and emphasis on f[subscript o] response magnitude were evaluated with repeated-measures analyses of variance. Relationships between adaptive f[subscript o] responses in sentences and vowels and between adaptive f[subscript o] and amplitude responses were evaluated with Spearman correlations. Results: Speakers adapted to f[subscript o] errors in both linguistically meaningful sentences and linguistically neutral vowels. Adaptive f[subscript o] responses of unemphasized words were smaller than those of emphasized words when f[subscript o] was shifted upward. There was no relationship between adaptive f[subscript o] responses in vowels and emphasized words, but adaptive f[subscript o] and amplitude responses were strongly, positively correlated. Conclusions: Sensorimotor adaptation occurs in response to f[subscript o] errors regardless of how disruptive the error is to linguistic meaning. Adaptation to f[subscript o] errors during sustained vowels may not involve the exact same mechanisms as sensorimotor adaptation as it occurs in meaningful speech. The relationship between adaptive responses in f[subscript o] and amplitude supports an integrated model of prosody.

This paper explores what the measures of utterance fluency typically employed in Automatic Speech Evaluation (ASE), i.e. automated speaking assessments, tell us about oral proficiency. 60 Chinese learners of English completed the second part of the speaking section of IELTS and six tasks designed to measure the linguistic knowledge and processing assumed to underpin second language speech production. A sample of eight native speakers rated the learners' oral productions for functional adequacy. Analyses of the data confirm: (1) articulation rate, mid-clause pause frequency, and repetition frequency predict functional adequacy, (2) breadth of lexical knowledge is the main predictor of articulation rate as well as functional adequacy, (3) speed of syntactic processing predicts end-clause pause duration and speed of lexical processing predicts mid-clause pause duration, and (4) measures of utterance fluency together account for 60% of the variation in functional adequacy scores. These findings suggest that articulation rate best reflects overall functional adequacy. Moreover, other measures of utterance fluency reflect different areas of underlying knowledge and processing, opening up the possibility of automating diagnostic speaking tests.

Background and Objectives: Evidence suggests telehealth in speech and language therapy can enhance access to care, cost-effectiveness and satisfaction. However, little is known about use of telehealth in the United Kingdom. Moreover, many assessments/outcome measures for aphasia have been tested for face-to-face administration only, posing challenges to reliable use within the telehealth context. We explored the experiences and views of speech and language therapists (SLTs) working with people with aphasia on using telehealth to conduct assessments/outcome measures, perceived barriers and facilitators in telehealth, and their priorities for research in telehealth aphasia assessment. Method: We explored views of UK SLTs through an online cross-sectional survey (2021) delivered through the Qualtrics platform. The survey covered three main areas: (i) participant demographics; (ii) experience of using telehealth and doing telehealth assessments with people with aphasia post-stroke during the COVID-19 pandemic; and (iii) plans for telehealth post-pandemic. Response formats included yes/no, multiple choice, 5-point Likert scales and open-ended text responses. The survey was expected to take no more than 10 min to complete. Survey data were analysed through descriptive statistics and content analysis of open-ended questions. Results: One hundred twenty-four SLTs responded to the survey. The majority (>80%) used telehealth during the COVID-19 pandemic and >90% planned to continue to use telehealth in the future. The most used platforms were Zoom, Microsoft Teams and Attend Anywhere. Access to internet and telehealth platforms, and practical problems (e.g., difficulties sharing resources online, limited functionality of telehealth platforms for assessment) were common barriers. Therapists highlighted that training, resources and materials that assist the administration of assessments were important. Most participants responded that there was a need for existing measures to be tested for administration via telehealth (n = 68, 70.8%). Participants overall felt there was a need for online interactive assessments, more online resources that have been trialled for use via telehealth, accessible formats for resources for people with aphasia and clear instructions for how people with aphasia can access resources. Conclusions: This study provides new insights into the current use of telehealth assessment with people with aphasia in the United Kingdom and directions for future research. Barriers and facilitators identified can support the implementation of telehealth assessment in SLT services.

Background: Spoken discourse is commonly affected after traumatic brain injury (TBI). Although guidelines recommend prioritizing discourse-level skills in cognitive communication management, previous literature has highlighted challenges in managing discourse clinically. Little is known about how speech-language pathologists (SLPs) assess and treat discourse after TBI. Aims: To investigate current SLP practice to determine the alignment of clinical practice with research evidence and recommendations. Methods & Procedures: This online survey consisted of 30 questions on SLPs' practice with discourse assessment, analysis and treatment processes, including the materials and methods used and rationales for decision-making. Participants were recruited through national and international SLP professional bodies, TBI-specific or SLP special-interest groups and social media. Survey responses were analysed using descriptive statistics, with free text included to support individual responses. Outcomes & Results: There were 70 participants, from Australia, the United States, UK and New Zealand. Nearly half the participants had over 11 years of experience working with adults with TBI and a quarter had over 20 years of experience. Participants reported that they regularly evaluated the discourse ability of people with TBI, most commonly during spontaneous conversation or with a personal narrative task. Discourse intervention approaches mostly targeted client self-monitoring ability, social skills or conversational interactions. Practice varied dependent on setting, with more SLPs in community or outpatient services undertaking discourse assessment and treatment than in hospital settings. Conclusions & Implications: Overall, survey respondents' management of spoken discourse aligned with recommendations in the research literature, incorporating an individualized, goal-based approach. Factors affecting the use of discourse in practice included client-specific factors and needs, availability of time for transcription and analysis, and SLPs' knowledge level and confidence with discourse. Increased knowledge of discourse methods and treatment approaches could help inform decision-making for SLPs working in TBI.

Purpose: Apraxia of speech (AOS) is a motor speech disorder affecting articulatory planning and speech programming. When AOS is the sole manifestation of neurodegeneration, it is termed primary progressive apraxia of speech (PPAOS). Recent work has shown that there are distinct PPAOS subtypes: phonetic, prosodic, and those that do not clearly align with either (mixed). PPAOS subtypes differ with respect to the predominating motor speech difficulties, as well as disease progression and underlying pathology. Because past studies have determined PPAOS subtype based on clinical impression, the goal of the present study was to quantitatively determine the distribution of speech error types across PPAOS subtypes in a word repetition task and to investigate how word complexity affects the type and number of speech errors across PPAOS subtypes. Method: Forty-five patients with PPAOS (13 phonetic, 23 prosodic, and nine mixed) and 45 healthy controls produced multiple repetitions of words that varied in phonetic complexity. Sound additions, deletions, and substitutions/distortions (phonetic errors) and within-word segmentations (prosodic errors) were calculated. Results: All three PPAOS groups produced significantly more errors than controls, but the total number of errors was comparable among subtypes. The phonetic group produced more phonetic-type errors compared to the prosodic group but comparable to the mixed group. The prosodic group produced more segmentations compared to the phonetic and mixed PPAOS groups. As word complexity increased, the total number of errors increased for PPAOS patients. The phonetic and prosodic groups were more likely to produce phonetic- and prosodic-type errors, respectively, as word complexity increased. Conclusions: This study provides novel quantitative data showing that PPAOS subtype can be supported by the type and distribution of speech errors in a word repetition task. This may facilitate earlier, more reliable differential diagnosis and aid in disease prognosis, as PPAOS subtypes have distinct disease trajectories.

Second language (L2) researchers have long acknowledged the role of language anxiety in communication processes, such that learners with greater language anxiety tend to be less willing to engage in communication. However, little research has explored links between L2 speakers' perceptions of conversation and dynamic measures of anxiety. Therefore, this study measured 60 L2 English speakers' galvanic skin response (a physiological index of anxiety) during conversation. After the conversation, speakers evaluated themselves and their partner in terms of speech fluency and comprehensibility, engagement, and anxiety, and responded to trait-anxiety and social network questionnaires. Correlational analyses explored relationships between speakers' trait-anxiety, social network characteristics, self- and peer-perceptions and five levels of physiological response during conversation. Findings revealed that high arousal during interaction was related to speakers' negative self-perceptions of speech fluency and negative perceptions of their partner's engagement. Implications are discussed regarding state-anxiety as triggered by partner- or task-specific experiences.

The practice of second language (L2) speech perception has traditionally relied on equal-interval perceptual scales and novice listeners' (NLs) impressionistic judgments of constructs such as accentedness and comprehensibility (Munro & Derwing, 2011). However, issues have surfaced with respect to how well NLs can use these scales, whether they use the entire scale, and how valid/reliable their ratings are. This study draws inspiration from the work of Glenn Fulcher in the area of L2 speech assessment, specifically on construct validity and scale design (1993; 2003). The current study explores similar issues from the lens of the speech perception practice, relying on scale transformation methods and multi-faceted Rasch measurement to examine the overall question of an ideal equal-interval scale length. Speech ratings of L2 accentedness and comprehensibility were originally collected from 56 NLs on 9-point bipolar Likert scales. Statistical transformations from 9-point to 7- and 5-point scales were compared through several indices (i.e., listener consistency, listener severity, scalar point discrimination, and scale usage) across four common speech tasks (i.e., read-aloud, spontaneous speech, elicited imitation, and picture description) (see Thomson & Derwing, 2015). With every statistical scale length reduction across four tasks, listeners' consistency improved, their levels of severity slightly decreased, and their scalar usage became more precise. Implications for L2 speech perception research suggest that the shorter 5-point perceptual scale shows potential in increasing the reliability and validity of scoring, while more appropriately distinguishing among speaker ability levels.

Purpose: The purpose of this tutorial is to guide practitioners to a critical praxis of speech, language, and hearing. This tutorial provides a foundational knowledge of critical theory as an approach to framing, conceptualizing, and interpreting phenomena and demonstrates its application to the speech, language, and hearing profession. Method: This tutorial reviews critical theory as a category of frameworks that challenge existing power structures and provides a critical analysis of the profession's approach to language using a raciolinguistic framework. Questions are included for the reader to guide self-reflection and preparation for enacting a critical praxis oriented toward justice. Recommended readings are provided for the reader to continue the journey beyond these pages. Results: The author presents a critical praxis of speech, language, and hearing, drawing directly from two additional critical frameworks: Black fugitivity and culturally sustaining pedagogy. This critical praxis is discussed within the context of three major areas--activism, assessment, and intervention--with a reconsideration of how to leverage skills, resources, and strategies in a way that centers (racial) identity formation and multimodal communication. Conclusion: Next steps are suggested, and readers are invited to become theorists who continue to develop a critical praxis for their context.

Purpose: This review article critically interrogates the history and the current practice of standardized assessment in speech and language therapy. Speech and language assessments utilizing standardized linguistic norms are a critical tool for constructing disability and controlling disabled individuals. Such practices are rooted in a medical model of disability where the linguistic practice(s) of the individual is pathologized to create normalcy and disorder. Method: We examine how these practices are anchored in eugenics and the racist logics of intelligence testing in which racialized populations were rendered as linguistically and biologically inferior. Results: This review article shows how ideologies governing standardized assessments are influenced by racism, ableism, and the nation-state and serve as foundational mechanisms to enable surveillance and capital production. It demonstrates how standard language ideologies are central to standardized testing. Speech and language therapy practices upholding these ideologies contribute to unrestrained wealth generation for the testing industry. Conclusions: The review article ends with a call for clinicians, educators, and researchers to critically examine the relationship between standardized assessment, race, disability, and capitalism in speech-language therapy. This process will contribute toward dismantling the hegemonic role of standardized assessment in oppression and marginalization of speech and language-disabled individuals.

This study examined the validity of data collected from a novel online story retell task. The task was specifically designed for use by junior school teachers with the support of speech-language therapists or literacy specialists. The assessment task was developed to monitor children's oral language progress in their first year at school as part of the Better Start Literacy Approach for early literacy teaching. Teachers administered the task to 303 5-year-olds in New Zealand at school entry and after 20 weeks and 12 months of schooling. The children listened to a story with pictures via iPad presentation and were then prompted to retell the story. The children's spontaneous language used in their story retell was captured and uploaded digitally via iPad audio recording and analyzed using semi-automated speech recognition and computer software. Their responses to factual and inferential story comprehension questions were also analyzed. The data suggested that the task has good criterion validity. Significant correlations between story retell measures and a standardized measure of children's oral language were found. The Better Start Literacy Approach story retell task, which took approximately 6 min for teachers to administer, accurately identified children with low oral language ability 81% of the time. Growth curve analysis revealed that the task was useful for monitoring oral language development, including for English as second language learners. Boys showed a slower story comprehension growth trajectory than girls. The Better Start Literacy Approach story retell task shows promise in providing valid data to support teacher judgement of children's oral language development.

Purpose: The purpose of this study was to explore whether evidence for a bimodal distribution of tense marking, previously documented in clinically referred samples, exists in a population-based sample of kindergarten children from a rural county in Tennessee. Method: A measure of tense marking, the Test of Early Grammatical Impairment (TEGI) Screening Test, was individually administered to consented kindergarten students (N = 153) across three elementary schools in a single school district. The consented children constituted 73% of kindergartners in the district. Cluster analysis was used to evaluate the number and composition of latent classes that best fit the distribution of the TEGI Screening Test scores. Results: Analysis of the scores revealed a distribution that deviated significantly from normality. Cluster analyses (Ward's, k-means, single linkage) revealed a two-cluster solution as the best fitting model. The very large effect-size difference in mean TEGI Screening Test score between the two clusters (d = 4.77) provides validation of an identifiable boundary delineating typical from atypical tense marking in this sample of kindergartners. The difference in tense marking across the two clusters was not attributable to child chronological age. The percentage of the sample comprising the low-performing cluster aligns with specific language impairment and developmental language disorder prevalence estimates. Conclusion: Additional demonstrations of a bimodal distribution of tense marking in future studies with carefully defined samples could strengthen the clinical marker evidence and utility of this linguistic feature.

Purpose: Language sample analysis is widely regarded as the gold standard of language assessment. However, the uncertainty regarding the optimal length of sample and the limited availability of developmental language data for nonmainstream languages such as Afrikaans complicate reliable use of the method. The study aimed to provide guidelines on representative length of sample and concurrently provide a preliminary description of the spoken language skills of Afrikaans-speaking children. Method: The study involved 30 typically developing Afrikaans-speaking children aged between 3;6 and 9;6 (years;months). A descriptive research design was used to transcribe and analyze 1-hr interactions collected in natural environments of participants who were recruited using referral sampling. Video and audio recordings of the samples were transcribed using adapted Sampling Utterances and Grammatical Analysis Revised analysis procedures. Results: Results indicated that mean length of utterance in words per minute, number of different words per minute, and total number of words per minute stabilized at 30 min and no significant differences were found between 30 min and longer time segments. Morphology results concur with existing developmental findings in Afrikaans. Lexical diversity results correlated with the findings of the lexical specificity and accuracy in the Prutting and Kirchner Pragmatic Protocol (Prutting & Kirchner, 1987). The developmental trajectories for pragmatic and phonological development were consistent with existing guidelines. Conclusions: The study concluded that a 30-min interaction segment provides a representative language sample for Afrikaans-speaking children who are between 3;6 and 9;6. It provides promising preliminary developmental data and clinical guidelines, confirming the potential of language sample analysis (LSA) as a reliable component of language assessment in Afrikaans.

Purpose: The purpose of this study was to examine the differences between the age of acquisition (AoA) and sentence length of sentences of the speech recognition (SR) tests for adults and children in Dutch, American English, and Canadian French. Method: The AoA and sentence length of the sentences of four SR tests for adults and children were determined. One-way analyses of variance were performed to assess differences between the tests. Results: The AoA and sentence length of the sentences significantly differed between the SR tests for adults. These differences were also found between the SR tests for children. Conclusions: The AoA and the sentence length differ across the SR tests in Dutch, American English, and Canadian French. The Dutch sentences have higher AoA and are longer than the sentences in American English and Canadian French. The effect of the linguistic complexity on sentence repetition accuracy should be investigated during the development and validation of a Dutch SR test for children.

Background: We discuss a free software system (Computerized Language Analysis [CLAN]) that can enable fast, thorough, and informative language sample analysis (LSA). Method: We describe methods for eliciting, transcribing, analyzing, and interpreting language samples. Using a hypothetical child speaker, we illustrate use KidEval to generate a diagnostic report. Results: Given LSA results suggestive of expressive language delay, we analyze further using CLAN's Developmental Sentence Score and Index of Productive Syntax routines, and outline the child's use of Brown's morphemes. Discussion: This tutorial provides an introduction to the use of free CLAN software. We discuss how LSA results can be used to structure therapy goals that address specific aspects of grammatical structure that the child may not yet demonstrate in their spoken language. Finally, we provide answers to common questions, including user support.

As children age, they are less likely to experience spontaneous recovery from stuttering and are likely to develop negative attitudes about talking, necessitating counselling to address these feelings. The current exploratory case study examines children's response to traditional speech therapy to address fluency combined with a programmed message to modify negative attitudes about talking. A standard narration, saved to a compact disk (CD), was used as a counselling experience for children, ages 6, 7, and 10;11 years, recruited from a university clinic predominantly serving African American children. A one-tailed Mann-Whitney U-test was performed to examine differences in stuttering across three pretreatment sessions to treatment results from two experimental sessions. The analysis indicated that participants who completed the two treatment sessions stuttered significantly less during the sessions that included the CD, with a moderate clinical effect size as indicated by r, (Mdn = 9), U = 12, p [less than or equal to] 0.05, r = 0.53. For 2 of 3 participants who completed post-testing with the Stuttering Severity Instrument-3 (SSI-3), testing indicated a reduction in overall scores and stuttering severity (Riley, 1994). There is a need for future studies to examine the content of motivational messages as components of therapy to address stuttering.

Purpose: Bilingual children often demonstrate a high rate of disfluencies, which might impact the diagnostic evaluation of fluency disorders; however, research on the rates and types of disfluencies in bilinguals' two languages is limited. The purpose of this research is to profile disfluencies of two types, stuttering-like disfluencies (SLDs) and other disfluencies (ODs), in the speech of Russian-Hebrew bilingual typically developing children, focusing on cross-linguistic differences and the effect of language proficiency in both languages. Method: Spontaneous narratives based on the "Frog, Where Are You?" (Mayer, 1969) picture book were collected in both languages from 40 bilingual Russian-Hebrew children aged 5;6-6;6 (years;months). The transcribed narratives were coded for SLD (sound, syllable, and monosyllabic word repetitions) and OD (multisyllabic word/phrase repetitions, interjections, and revisions), and their frequencies per 100 syllables were calculated. Results: Overall, most children had a percentage of SLD and OD below the cutoff point and within the existing criteria for stuttering diagnosis established based on monolingual data, but several children exceeded this stuttering criterion. Monosyllabic word repetitions (part of SLD) and interjections (part of OD) were more frequent in Hebrew than in Russian. Lower proficiency was associated with a higher percentage of monosyllabic word repetitions and of interjections in both languages. Conclusions: Bilingual disfluency criteria are needed, since based on the existing monolingual criteria, some children might be erroneously assessed as children who stutter, thus leading to overdiagnosis. The results support the claim that proficiency is an important factor in the production of disfluencies.

Covert contrast is the statistically reliable distinction between target language phonemes produced in the process of language acquisition that is nevertheless not perceived by a native speaker of that language. This paper examines the acquisition of contrasts in four Najdi Arabic fricatives, /s/, /[voiceless palato-alveolar fricative]/, /[voiceless dental fricative]/, and /[voiced dental fricative]/, and seeks to identify the most common substitutions in producing these sounds. Words were elicited from 25 preschool children (aged 3-5 years). The target words contained the studied fricative followed by either long /a:/ or short /a/ in the initial position. Praat software was used for acoustic analysis to extract the four acoustic cues: center of gravity, fricative noise duration, F1, and F2. Participants performed a word repetition task and a picture elicitation task. The results showed six cases of covert contrast, seven cases of no contrast, and 87 cases of accurate production (overt contrast). The results also revealed stopping, gliding, and affrication as substitutions in the manner of articulation, while replacement in place of articulation occurred in backing but most commonly in fronting (24 cases). The present study sought to determine implications for children's linguistic performance, and, consequently, for language education and for planning treatment for children with speech disorders.

Purpose: The Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) is a standardized instrument used in voice assessment to assess voice quality. It has been translated and culturally adapted in several languages. This study aimed at developing and validating a Tamil version of CAPE-V through auditory perceptual evaluation of remotely recorded voice samples. Method: The Tamil version was adapted with permission from the American Speech-Language-Hearing Association to match the rationale in English CAPEV. The sentences were constructed by the first author and validated for content by two panels of experts. Forty-five participants (15 cases and 30 controls) were included in the study. Data recording was conducted online (Zoom Video Communications, Inc., app) for all samples. Three raters participated in the auditory evaluation and scored all samples using Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS) scale followed by CAPE-V with a week gap in between. Twenty percent of samples were repeated to assess intrarater reliability. The intrarater and interrater reliability measures for Tamil CAPE-V were established using intraclass coefficients (ICCs). To ensure construct validity, group differences were determined between the cases and controls. The concurrent validity was established by correlating Tamil CAPE-V with the GRBAS scale. Results: The intrarater reliability for Tamil CAPE-V ranged from moderate to excellent (ICC: 0.610--0.998). The Tamil CAPE-V obtained moderate to good interrater reliability for all parameters (ICC: 0.525--0.790) except pitch (ICC: 0.405). The differences between the cases and controls were statistically significant (p < 0.01). The correlation between CAPE-V and GRBAS was strong for overall severity, breathiness, and strain (r[subscript s] = 0.725--0.861) and moderate for roughness (r[subscript s = 0.678). Conclusion: The Tamil CAPE-V is a reliable and valid tool for auditory perceptual evaluation in Tamil-speaking populations.

Purpose: This study aimed to (a) relate temporal patterning of articulation to functional speech outcomes in neurologically healthy and impaired speakers, (b) identify changes in temporal patterning of articulation in neurologically impaired speakers, and (c) evaluate how these changes can be modulated by speaking rate manipulation. Method: Thirteen individuals with (ALS) and 10 neurologically healthy controls read a sentence 3 times, first at their habitual rate and then at a voluntarily slowed rate. Temporal patterning of articulation was assessed by 24 features characterizing the modulation patterns within (intra) and between (inter) four articulators (tongue tip, tongue body, lower lip, and jaw) at three linguistically relevant, hierarchically nested timescales corresponding to stress, syllable, and onset-rime/phoneme. For Aim 1, the features for the habitual rate condition were factorized and correlated with two functional speech outcomes--speech intelligibility and intelligible speaking rate. For Aims 2 and 3, the features were compared between groups and rate conditions, respectively. Results: For Aim 1, the modulation features combined were moderately to strongly correlated with intelligibility (R[superscript 2] = 0.51-0.53) and intelligible speaking rate (R[superscript 2] = 0.63-0.73). For Aim 2, intra-articulator modulation was impaired in ALS, manifested by moderate-to-large decreases in modulation depth at all timescales and cross-timescale phase synchronization. Interarticulator modulation was relatively unaffected. For Aim 3, voluntary rate reduction improved several intra-articulator modulation features identified as being susceptible to the disease effect in individuals with ALS. Conclusions: Disrupted temporal patterning of articulation, presumably reflecting impaired articulatory entrainment to linguistic rhythms, may contribute to functional speech declines in ALS. These impairments tend to be improved through voluntary rate reduction, possibly by reshaping the temporal template of motor plans to better accommodate the disease-related neuromechanical constraints in the articulatory system. These findings shed light on a novel perspective toward global timing-based motor speech assessment and rehabilitation.

The Focus on the Outcomes of Communication Under Six (FOCUS) is one of a few validated outcome measures related to children's communicative participation. Additional validation of the FOCUS measure could address the paucity of validated outcomes-based measures available for assessing preschool-age children, particularly for those who are multilingual. The data collected for this study, with a representative sample of Jamaican Creole-English speaking children, extend the applicability of the FOCUS to a broader range of preschoolers and expand psychometric evidence for the FOCUS to a multilingual and understudied context.

Purpose: Narrative assessment is one potentially underutilized and inconsistent method speech-language pathologists may use when considering a diagnosis of developmental language disorder (DLD). However, narration research encompasses many varied methodologies. This systematic review and meta-analysis aimed to (1) investigate how various narrative assessment types (e.g., macrostructure, microstructure, and internal state language) differentiate children with typical development (TD) from children with DLD, (2) identify specific narrative assessment measures that result in greater group differences, and (3) evaluate participant and sample characteristics that may influence performance differences. Method: Electronic databases (PsycINFO, ERIC, and PubMed) and ASHAWire were searched on July 30, 2019, to locate studies that reported oral narrative language measures for both DLD and TD groups between ages 4 and 12 years; studies focusing on written narration or other developmental disorders only were excluded. We extracted data related to sample participants, narrative task(s) and assessment measures, and research design. Group differences were quantified using standardized mean differences. Analyses used mixed-effects meta-regression with robust variance estimation to account for effect size dependencies. Results: Searches identified 37 eligible studies published between 1987 and 2019, including 382 effect sizes. Overall meta-analysis showed that children with DLD had decreased narrative performance relative to TD peers, with an overall average effect of -0.82 SD, 95% confidence interval [-0.99, -0.66]. Effect sizes showed significant heterogeneity both between and within studies, even after accounting for effect size-, sample-, and study-level predictors. Across model specifications, grammatical accuracy (microstructure) and story grammar (macrostructure) yielded the most consistent evidence of TD-DLD group differences. Conclusions: Present findings suggest some narrative assessment measures yield significantly different performance between children with and without DLD. However, researchers need to improve consistency of inclusionary criteria, descriptions of sample characteristics, and reporting of correlations between measures to determine which assessment measures reliably distinguish between groups.

Purpose: This study examined the relationship between voice quality and glottal geometry dynamics in patients with adductor spasmodic dysphonia (ADSD). Method: An objective computer vision and machine learning system was developed to extract glottal geometry dynamics from nasolaryngoscopic video recordings for 78 patients with ADSD. General regression models were used to examine the relationship between overall voice quality and 15 variables that capture glottal geometry dynamics derived from the computer vision system. Two experts in ADSD independently rated voice quality for two separate voice tasks for every patient, yielding four different voice quality rating models. Results: All four of the regression models exhibited positive correlations with clinical assessments of voice quality (R[superscript 2]s = 0.30-0.34, Spearman rho = 0.55-0.61, all with p < 0.001). Seven to 10 variables were included in each model. There was high overlap in the variables included between the four models, and the sign of the correlation with voice quality was consistent for each variable across all four regression models. Conclusion: We found specific glottal geometry dynamics that correspond to voice quality in ADSD.

Purpose: Vocal roughness is often present in many voice disorders but the assessment of roughness mainly depends on the subjective auditory-perceptual evaluation and lacks acoustic correlates. This study aimed to apply the concept of roughness in general sound quality perception to vocal roughness assessment and to characterize the relationship between vocal roughness and temporal envelop fluctuation measures obtained from an auditory model. Method: Ten /[open back unrounded vowel]/ recordings with a wide range of roughness were selected from an existing database. Ten listeners rated the roughness of the recordings in a single-variable matching task. Temporal envelope fluctuations of the recordings were analyzed with an auditory processing model of amplitude modulation that utilizes a modulation filterbank of different modulation frequencies. Pitch strength and the smoothed cepstral peak prominence were also obtained for comparison. Results: Individual simple regression models yielded envelope standard deviation from a modulation filter with a low center frequency (64.3 Hz) as a statistically significant predictor of vocal roughness with a strong coefficient of determination (r[subscript 2] = 0.80). Pitch strength and CPPS were not significant predictors of roughness. Conclusion: This result supports the possible utility of envelope fluctuation measures from an auditory model as objective correlates of vocal roughness.

Purpose: Laryngeal high-speed videoendoscopy (LHSV) has been recognized as a highly valuable modality for the scientific investigations of vocal fold (VF) vibrations. In contrast to stroboscopic imaging, LHSV enables visualizing aperiodic VF vibrations. However, the technique is less well established in the clinical care of disordered voices, partly because the properties of aperiodic vibration patterns are not yet described comprehensively. To address this, a computer model for simulation of VF vibration patterns observed in a variety of different phonation types is proposed. Method: A previously published kinematic model of mucosal wave phenomena is generalized to be capable of left-right asymmetry and to simulate endoscopic videos instead of only kymograms of VF vibrations at single sagittal positions. The most influential control parameters are the glottal halfwidths, the oscillation frequencies, the amplitudes, and the phase delays. Results: The presented videos demonstrate zipper-like vibration, pressed voice, voice onset, constant and time-varying left-right and anterior-posterior phase differences, as well as left-right frequency differences of the VF vibration. Video frames, videokymograms, phonovibrograms, glottal area waveforms, and waveforms of VF contact area relating to electroglottograms are shown, as well as selected kinematic parameters. Conclusion: The presented videos demonstrate the ability to produce vibration patterns that are similar to those typically seen in endoscopic videos obtained from vocally healthy and dysphonic speakers.

Introduction: Assessment of resonance characteristics is essential in research and clinical practice in individuals with velopharyngeal impairment. The purpose of this study was to systematically review correlations between auditory perceptual ratings and nasalance scores obtained by a nasometer in individuals with resonance disorders and to identify factors that affected the correlations between these two measures. Method: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search was conducted for studies reporting a correlation between nasality ratings and nasalance scores using six electronic databases based on predefined inclusion and exclusion criteria. Results: A total of 27 studies were included in this systematic review. Characteristics of study components including participants, types of assessment and stimuli, correlation coefficients, and reliability values of each study were identified, and a narrative synthesis was conducted. The methodological quality of each study was also appraised. The correlation level between nasalance values and nasality ratings varied from nonsignificant to strong (r = 0.92). The quality rating scores of the selected studies ranged from 44% to 94%, with an average score of 75%. Discussion: Factors that did or did not affect the varied correlation between nasality ratings and nasalance scores were discussed. Speech stimuli and the listeners' background were associated with correlations between the two measures. In addition, the sex of the speakers could be a factor affecting its correlation. However, the types of perceptual scales and listening conditions did not influence its correlations between the two measures.

Purpose: This study examined performance of dual language learners (DLLs) on Spanish- and English-language narrative story retells and unique tells. Transcription and analysis focused on comparisons of common microstructural language sample measures in Spanish and English across tasks. Each language sample measure was evaluated for its possible convergence with norm-referenced standardized assessments for DLL children. Method: Spanish-English DLLs (N = 133) enrolled in English-only kindergarten or first-grade classrooms completed two-language sample tasks (one in each language), which were transcribed and analyzed using Systematic Analysis of Language Transcripts (Miller & Iglesias, 2017) for measures of syntactic complexity (mean length of utterance [MLU] in words), lexical diversity (number of different words [NDW]), and grammaticality (percent grammatical utterances [PGU]). Students also completed a norm-referenced sentence repetition task (Peña et al., 2014) and expressive vocabulary assessment (Martin, 2013). Results: Comparison of story retells and unique stories revealed similar performance on MLU, NDW, and PGU across elicitation techniques, with one exception: NDW in Spanish was higher in the story retell condition. Predictive models revealed several differences in the relations between the microstructure measures and norm-referenced language measures by elicitation technique, although neither context demonstrated a consistent advantage across all metrics. Conclusions: Measures derived from story retells and unique tells offer practical findings for speech-language pathologists and other educators to use in assessment of early grade DLLs. This work increases knowledge of procedural differences across narrative assessments and their influence on language variables, supporting school-based speech-language pathologists in making assessment decisions for DLLs on their caseload.

Purpose: Our proof-of-concept study tested the feasibility of virtual testing using child assessments that were originally validated for in-person testing only. Method: Ten adult-child dyads were assigned to complete both in-person and virtual tests of language, cognition, and narratives. Child participants fell between the ages of 4 and 8 years; adult participants were speech-language clinicians or researchers with experience in administering child assessments. Half of child participants were Spanish-English bilinguals, and half were monolingual English speakers. Results: Results showed similar performance across in-person and virtual modalities on all assessments. Recommendations for adapting, administering, and scoring virtual measures with linguistically diverse children are discussed. Conclusions: Although additional research on virtual assessment is needed, our results open opportunities for appropriate remote assessment, particularly for bilingual children, who may not have in-person access to speech-language pathology services.

Purpose: The current study aimed to understand the clinical decision-making skills of school-based speech-language pathologists (SLPs) using narrative and expository discourse information from three sources: perception of language through listening to language alone, standardized criterion-referenced narrative assessment data, and word- and morpheme-level language sample analysis data. Method: Twenty-eight current school-based SLPs participated in the study. During this study, participants rated language quality and made decisions regarding the provision of language services after being provided information from informal assessment measures. Results: SLPs' ratings of language quality and complexity varied across the story retell, wordless picture book generation, and expository samples. There was a lack of consistency in ratings within each context across areas of clarity, sample complexity, language complexity, and vocabulary across all SLPs. Self-reported factors that influenced SLPs' ratings included components of structure, syntax, and semantics. SLPs did not indicate a need for services after listening alone. When provided with criterion-referenced narrative assessment scores and word- and morpheme-level language sample data, more SLPs made a recommendation for services. Conclusions: The study demonstrates the need for objective language measure data during diagnostic decision making. Additionally, SLPs may not realize the information obtained from real-time perception, and analysis of language samples may be an unreliable and inconsistent picture of a child's language abilities. The results of this study highlight the need to continue to rely on multiple sources of assessment data. SLPs should continue to incorporate systematic methods to minimize variability of perceptions in the process of making diagnostic decisions.

Purpose: Language sampling analysis (LSA) plays an important role in evaluating language skills; hence, the study aimed to develop new assessment measures for the LSA in Turkish as alternatives to mean length of utterance (MLU) and the Language Assessment, Remediation and Screening Procedure. With this aim, Developmental Sentence Scoring (DSS) and the Index of Productive Syntax (IPSyn) were adapted to Turkish. Method: Eighty monolingual Turkish children were included in the study, and the age range was from 2;0 to 5;11 (years;months). The children were grouped with 6-month intervals, and each group had an equal number of participants in terms of gender. Their general and language development were tested with standardized tests, and language sampling was recorded during play with farm toys for 15-20 min. Reviewing literature and observing participants' production schemas were created for DSS for Turkish (DSS-TR) and the IPSyn for Turkish (IPSyn-TR) separately, and final versions were determined in consultation with experts. Results: DSS-TR and IPSyn-TR were significantly correlated with standardized tests, and MLU values were statistically significant (p < 0.05). Total scores increased with age; however, grammatical categories did not go up. No difference was observed between genders (p > 0.05). In DSS-TR, the "sentence point" did not affect the participants' total scores because of language characteristics (p > 0.05). Finally, DSS-TR and IPSyn-TR were seen to be correlated with each other (p < 0.05). Conclusions: DSS-TR and IPSyn-TR are valid, being correlated with other assessment tools, and reliable, showing a high correlation with other raters, to reflect morphosyntactic skills. Therefore, they both are alternative assessment measures that will be used in LSA and give an opportunity to clinicians to plan their intervention goals. Also, they enable clinicians to observe progress not only specific to grammatical category but also in the total scores of the children either during or at the end of the therapy.

Purpose: Secretion bubbling on the superior aspect of the velopharyngeal (VP) valve typically occurs with a small VP opening during production of oral pressure consonants. The use of high-speed nasopharyngoscopy has shown correlation between the bubbling frequency and the acoustics captured with the nasal microphone of the nasometer. The purpose of this study was to investigate if the sound generated by the bubbling process is perceived as nasal rustle (also known as nasal turbulence). Method: Speech samples were extracted from the data of patients who were diagnosed with nasal rustle (five boys and five girls, ranging in age from 5 to 10 years old). A customized filter was used to remove the sound generated by the secretion bubbling. Six experienced listeners were asked to rate the perception of nasal rustle in each speech stimuli before and after the filtering process. Results: Rating values for the perception of nasal rustle were overall reduced in all cases after the filtering process. Furthermore, the perception of nasal rustle was eliminated in 40% of the cases. Rating reliability was excellent before the filtering process and moderate to good after filtering. Conclusion: Reducing the perception of nasal rustle using spectral filtering based on the bubbling frequencies supports the hypothesis that undesired sound in the nasal cavity is generated from the interaction of the turbulent airflow with the secretion bubbling.